Preventing Alcohol-exposed Pregnancies

Abstract

Fetal alcohol exposure affects approximately 1% to 3% of live births in the United States. Family physicians are in a unique position to reduce the incidence of alcohol-exposed pregnancy. Fetal alcohol exposure can be minimized through 2 general approaches: reducing alcohol consumption or increasing effective contraception among childbearing-aged women who engage in "at-risk" drinking and encouraging pregnant women to abstain from alcohol. Although no safe level of alcohol consumption during pregnancy is established, women who binge drink are more likely to deliver infants with physical and cognitive-developmental anomalies. Screening tools, such as quantity/frequency questions, the TWEAK and the T-ACE, developed specifically for prenatal care, are more useful with women than the CAGE and Michigan Alcohol Screening Test (MAST). Screening alone seems to reduce alcohol use among pregnant women. Brief interventions, including education about alcohol's effects on the developing fetus, are effective among women not responding to screening. Unfortunately, many barriers exist to effective implementation of alcohol-exposed pregnancy (

Predictors of risk of alcohol-exposed pregnancies among women in an urban and a rural area of South Africa

“…Most variables that we found to be associated with being at risk of an AEP are similar to those identified previously (e.g., Mengel et al, 2006;Project Choices Research Group, 2002). However, unlike other studies, we did not find mental and physical health perceptions to be significantly associated with being at risk of an AEP.…”

“…Religiosity was identified as a protective factor. These maternal risk and protective factors for FAS are not dissimilar to the factors associated with being at risk of an AEP that have been identified in other parts of the world (Mengel, Searight, & Cook, 2006;Project Choices Research Group, 2002).…”

A Randomized Phase I Trial of a Brief Computer-Delivered Intervention for Alcohol Use During Pregnancy

“…51,52 For example, several studies have already identified factors that increase the risk of alcohol use during pregnancy, including low (SES), having an early age of drinking onset, being unmarried, and reporting heavy drinking by male partner. [53][54][55][56][57] It may be that screeners using indirect risk factors, such as 1522 TZILOS ET AL.…”

Factors associated with female high-risk drinking in a rural and an urban South African site

“…Women of lower SES, and women who currently smoke, may also benefit from screening and brief interventions in the clinical setting. 11 Further research into high-risk drinking among women, and prevention strategies, are urgently required in South Africa.…”